Development of a screening tool for predicting the risk of leftover medicines in diabetic patients who take oral diabetic medications
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Abstract
Leftover medicines or oversupplies of prescribed medications associated with high cost and hospitalization risk. Especially in patients with chronic diseases such as diabetes. In the past, there has been a predicting leftover medication from logistic regression or decision tree techniques but not have screening tools for easy to use. Objective: To develop the screening questionnaires in diabetic patients who are at risk of having the leftover medicines by using Logistic Regression. Method: To find the factors effect on having the leftover medicines by interviewing and data collecting from patient’s database. Study on 800 diabetic patients who received the treatment at diabetic clinic in Sirindhorn Hospital and Sub-district Health Promoting Hospital in Sirindhorn district, Ubon Ratchathani Province from July - December 2016. Leftover medicines were collected from returned medicines, counting only oral diabetic medications. Using Logistic Regression to analyses factors that related to the leftover medicines and developed screening questionnaires from these factors. Results: From the sample, 179 patients (22.3 % of all samples) had the leftover medicines in accordance with this research definition (Medication possession ratio (MPR) > 1.2). By using Logistic Regression to analyse, found 3 statistical significance factors that related to the leftover medicines which were alcohol consumption history, merital status single, divorced or separated and pill count more than 5 pills per day increased the risk of having leftover medicines. The screening questionnaires in Diabetic Patients who are at risk of having the leftover medicines were developed from these factors. This questionnaires contain 0-8 score. Those who had more than 3 scores were at risk of having the leftover medicines. The sensitivity of this developed questionnaires is 49.72 percent. Specificity is 65.05 percent and receiver operating characteristic curve (Receiver Operating Characteristic (ROC) curve) is 60.4 (95% confidence interval (95%CI), 55.7-65.1). Conclusions: The developed screening questionnaires in Diabetic Patients who are at risk of having the leftover medicines was found the factor effect on having the leftover medicines It should be improve the screening questionnaires to be more accurate.
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